tbuckley/cabot-search huggingface dataset:
AB0367 ANXIETY AND DEPRESSION IN RHEUMATOID ARTHRITIS DISEASE: A CROSS SECTIONAL STUDY AMONG 100 TUNISIAN PATIENTS
Authors: M. Brahem, A. Khemiri, A. Ben Salem, O. Jomaa, R. Sarraj, H. Hachfi, Y. Mohamed
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid Arthritis (RA) is a common chronic inflammatory disease, which can lead to structural joint damage and important handicap. RA is associated with pain, fatigue, functional disability and deterioration of emotional state that influence people's lives and may cause psychiatric signs and symptoms, particularly anxiety and depression. <h3>Objectives</h3> The present study aims to Assess the frequency of anxiety and depression in patients with RA and to determine their associated factors. <h3>Methods</h3> This is a cross sectional study conducted among patients followed in the rheumatology department at TAHER SFAR University Hospital in Mahdia. All patients were diagnosed with rheumatoid arthritis based on ACR/EULAR criteria. We included only patients without any previous psychiatric history and assessed them for anxiety and depression symptoms using the Hospital Anxiety and Depression scale (HADS) after a clear consent. <h3>Results</h3> We included in our study 100 patients with a mean age of 53.2 years (±11.21). The average duration of disease was 11.1 ± 8.9 years. The assessment of the RA activity showed a severe activity RA in 34% of participants. After analyzing the questionnaire results, according to HADS, the mean HAD-D score was 8.39 ±3.84 with 30% of definite depressed patients while the mean HAD-A score was 7.79± 3.6 with 24 patients presenting definite anxiety disorder. A significant association was found between the presence of depressive disorder and high disease activity (p&lt;0.01), higher HAQ level (p=0.02), higher NTJ (Number of Tender Joints) (p&lt;0.01), NSJ (Number of Swollen Joints) (p&lt;0.01) and higher VAS (Visual Analogue Scale) (p=0.04). Anxiety was also associated with severe activity stage (p&lt;0.01), higher HAQ level (p&lt;0.01), higher NSJ (p=0.01) and NTJ (p&lt;0.01). <h3>Conclusion</h3> Our study showed that more than quart of RA patients suffers from anxiety and/or depression, and these troubles were related essentially to active disease and functional disability. Screening for these disorders and the management of the RA activity will be necessary during follow up of our patients to ameliorate their quality of life. <h3>Reference</h3> [1] Fakra E, Marotte H. Rheumatoid arthritis and depression. Joint Bone Spine 2021. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0554 LOW-DOSE IL-2 CHANGED THE PROPRTION OF LYMPHOCYTE SUBSETS IN PATIENTS WITH PRIMARY SJOGREN’S SYNDROME
Authors: X. M. Wang, Q. Y. Su, J. X. Zhang, P. H. Chai, H. C. LI, Q. Yu, P. F. He, X. LI, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Primary Sjögren's syndrome (pSS) is a chronic inflammatory autoimmune illness characterized by various immune abnormalities. Abnormalities in the proportions of blood T lymphocyte subtype, that is Th17/Treg, were detected in pSS patients. Interleukin (IL)-2 is a crucial cytokine for tipping the balance of regulatory T(Treg) cells and effector T cells, which can effectively relieve pSS. <h3>Objectives</h3> This study aimed to systematically evaluate the changes in the number of lymphocyte subsets after low-dose IL-2 therapy for pSS. <h3>Methods</h3> Systematic searches of PubMed, EMBASE, Web of Science, the Cochrane Library and Medline, CNKI, CBM, and Technology Journal Database were performed. Original case reports, case series, observational studies, and clinical trials reporting the changes in lymphocyte subsets on pSS patients treated with IL-2 were included. A random-effects meta-analysis was performed to calculate the pooled efficacy. Inconsistency was evaluated by using the I <sup>[2]</sup>, and Egger tests were used for the evaluation of potential publication bias (STATA v.12.0) <h3>Results</h3> A total of 3 studies comprising 929 patients were identified(Table 1). The numbers of Th17 cells and Tregs were significantly increased after IL-2 injection [SMD=0.325, 95%CI (0.060,0.590), P=0.016; SMD=1.085, 95%CI(0.469,1.701), P=0.001], while there were no statistical differences in the ratio of Th17/Tregs[SMD=-0.263, 95%CI (-0.602,0.076), P=0.129]between before and after IL-2 treatment(Figure 1). <h3>Conclusion</h3> Low-dose IL-2 was promising in treating pSS, which could promote the proliferation and functional recovery of Tregs and regulate the balance between Treg cells and effector T cells towards Treg cells. <h3>Acknowledgements</h3> This work was supported by the National Natural Science Foundation of China (No. 82001740). <h3>Disclosure of Interests</h3> None Declared.
AB0661 CHANGES OF LYMPHOCYTE SUBSETS IN CONNECTIVE TISSUE DISEASE(CTD) WITH DIFFERENT TYPES OF PATHOGEN BLOODSTREAM INFECTIONS
Authors: R. Su, C. Wang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The underlying cause of autoimmune diseases is not known,infections, especially viral infections, is thought to be a possible reason[1].Disorder of CD4+T cells have been linked to autoimmunity, they are key players in various autoimmune diseases but are also crucial for immunity against different infections[2]. However, the immune response status of different types of infections in the context of autoimmune diseases is poorly understood. <h3>Objectives</h3> To evaluate the differences of lymphocyte subsets in connective tissue disease(CTD) with different types of pathogen bloodstream infections. <h3>Methods</h3> We analyzed 40 CTD patients with bloodstream infections, including 11 with virus infections,7 with fungal infections,13 with Gram negative bacteria infections(G- infection), 9 with Gram positive bacteria infections(G+infection), and 10 newly diagnosed CTD patients without co-infection were included as controls.The percentage and absolute numbers of lymphocyte phenotypes and CD4+ T subsets in peripheral blood were examined by flow cytometry. <h3>Results</h3> There were no significant difference in the percentage and absolute value of T,B,NK,CD4+T,CD8+T cells in different types of infection groups and no-infection group. Among comparison of the CD4+T subsets, the percentage of Th2 in the fungal infection was decreased than G- infection group and no-infection group,while the G- infection was increased than G+infection,and the virus infection was increased than fungal infection. The percentage of Th1,Th17 and Treg had no significant difference between different groups. Whereas for the absolute value comparison, the absolute value of Treg cells in the virus infection was higher than the fungal infection,G- infection and G+ infection, meanwhile the the fungal infection was obvious lower than no infection group. But there was no significant difference in Th1 and 17 among all groups. <h3>Conclusion</h3> Different types of pathgen blood may lead to development of specific immunological dysbalance,especially in the case of autoimmune disease hosts. CTD patients with fungal infection had lower Th2 response, higher Treg cells may be a characteristic of CTD combined with virus infection compare with other types of infection. <h3>References</h3> [1]Bjornevik K, Cortese M, Healy BC, Kuhle J, Mina MJ, Leng Y, Elledge SJ, Niebuhr DW, Scher AI, Munger KL, Ascherio A. Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Science. 2022 Jan 21;375(6578):296-301. [2]Quaglia M, Merlotti G, De Andrea M, Borgogna C, Cantaluppi V. Viral Infections and Systemic Lupus Erythematosus: New Players in an Old Story. Viruses. 2021,13(2):277. <h3>Disclosure of Interests</h3> None declared
AB0194 PROGRESSION OF RHEUMATOID PULMONARY NODULES: WHAT ARE THE PREDICTIVE FACTORS?
Authors: G. Sandal Uzun, Y. Sarikaya, E. B. Ata, M. Ekici, S. Arslan, E. Bilgin, G. Durhan, L. Kiliç, U. Kalyoncu, M. Ariyürek
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Pulmonary rheumatoid nodule(RPN) is an serious extraarticular manifestation of rheumatoid arthritis (RA). The clinical features and activity of the RA, used DMARDs and the characteristics of the nodule may affect the progression of the RPN. [1] <h3>Objectives</h3> To identify the characteristics of the PRN and factors affecting its progression. <h3>Methods</h3> In this study, 4117 patients with RA according to the ICD-10 code from the hospital database and who had at least one computed tomography (CT) were identified. The RA diagnosis of the patients were confirmed by examining the medical files (history, physical examination, radiography and laboratory evaluations). Then, chest CTs of the patients with confirmed RA diagnosis were examined by an experienced radiologist. To classify pulmonary nodules as ''pulmonary rheumatoid nodule'', following inclusion and exclusion criteria were used; For inclusion: 1) nodules with changing dimension on follow-up, 2) At least two nodules with different dimensions, 3) Cavitary nodule at any chest CT. For exclusion: 1) Solitary nodules OR all nodules ≤ 5mm and without follow-up OR no change on follow-up. Biggest nodule was named as dominant nodule. Then, patients were grouped according to status of progression. Progression was defined as growth or new nodule formation. <h3>Results</h3> Of 680 RA patients who had pulmonary nodule in chest CT, 208 (30.6%) patients were classified as having PRN. Of these patients, 135 had at least one control chest CT for PRN follow-up and were included in the study. The median disease duration from diagnosis of RA to baseline CT with PRN was 6.74(0.1-33.9) years. Before the baseline CT, 59 (43.7%) patients were recieving methotrexate and it was discontinued in 22 (37.2%) patients after RPN detection. 39 (28.9%) patients had PRN progression on their final chest CT compared to baseline. The median duration between baseline and final CT was 1.58(0.04-33.81)years. Anti-CCP positivitiy(OR 3.39, %95 CI 1.15-9.94), usage of bDMARDs between baseline and last CT (OR 2.48, %95 CI 1.1-5.5), cavitation (OR 3.31, %95 CI 1.5-7.4) and diameter of dominant nodules at baseline CT (OR 1.03, CI %95 1.00-1.07) were significantly assosiated factors with progression in RPN. <h3>Conclusion</h3> Our study shows that there are multiple factors that predict RPN progression. Especially the presence of cavitary nodules and seropositivity is important.Although clinicians tend to discontinue MTX when RPN is detected, MTX is not associated with RA nodule progression. <h3>Reference</h3> [1]Karadeniz, H., et al., <i>Treatment with biologic DMARDs may not adversely affect lung nodules in rheumatoid arthritis patients.</i> Eur J Rheumatol, 2022. <b>9</b>(2): p. 75-81. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0378 RELATIONSHIP BETWEEN EGO STATE, DISEASE ACTIVITY, AND ACTIVITY OF DAILY LIVING IN RHEUMATOID ARTHRITIS PATIENTS: USING EGOGRAMS
Authors: Y. Miwa, Y. Miwa, H. Tomioka, M. Hosaka
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Although there have been several previous reports on the personality patterns of rheumatoid arthritis (RA) patients and their habits and tendencies in thinking, feeling, and behaving when interacting with others (ego state), there have been no new research reports in the last ten years. During this period, the treatment outcome of RA has improved, and changes in ego states are expected. <h3>Objectives</h3> This study investigated the relationship between ego state, disease activity, and activity of daily living (ADL) in RA patients. <h3>Methods</h3> A total of 133 RA patients attending outpatient clinics at Showa University Hospital and Showa University Northern Yokohama Hospital who agreed to participate in this study were included. The patient background had age, gender, type of DMARDs, and prednisolone use; the simplified disease activity index (SDAI) was used to assess RA disease activity, and the health assessment questionnaire (HAQ) was to sed determine ADL. The University of Tokyo Egogram (TEG-II) was to sed determine ego status; the TEG-II consists of pattern categories and types from critical parental ego (CP), nurturing parental ego (NP), adult ego (A), free child ego (FC), and submissive child ego (AC). The scores for each item were evaluated, and associations with SDAI, HAQ, and gender were examined. <h3>Results</h3> The AC was the highest (15.0 points), and the CP and A were the lowest (6.0 points each) on the TEG-II for all the subject patients. The pattern classification showed that the AC-dominant type was the most common (45 patients, 33.8%), with no significant difference in HAQ remission (&lt;0.5) and non-remission, low disease activity (SDAI≤11) and SDAI&gt;11, nor in gender. <h3>Conclusion</h3> In previous reports, TEG-II in RA patients was predominantly NP, but in the present study, AC was predominant. The behavioral pattern was inferred to be cooperative, honest, able to listen to other's opinions, and patient, but loose, lax, lack discipline, inconsistent in thought and action, and poor planning. The results may be influenced by the improvement of rheumatoid arthritis performance and the decrease in disease activity. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0240 RHEUMATOID ARTHRITIS CLINICAL ACTIVITY IS NOT ASSOCIATED TO CARDIOVASCULAR RISK AS MEASURED BY TRADITIONAL RISK SCALES
Authors: J. R. Azpiri-López, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado, V. M. Beltran-Aguilar, V. Gonzalez-Gonzalez, A. G. Arias Peralta, N. De Avila Gonzalez, J. A. Cardenas-de la Garza, G. García-Arellano
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) patients have a higher cardiovascular risk (CVR) than the general population, being atherosclerotic cardiovascular disease the main cause of mortality [1]. Such increased could be explained by traditional CVR factors and chronic inflammatory state of disease. Clinical activity of disease, which is evaluated by DAS-28, is a parameter that denotes the current inflammatory status. [2] <h3>Objectives</h3> To compare CVR, by six scales: ACC/AHA ASCVD 2013, Framingham lipids and BMI, SCORE2, QRISK3 and Reynolds risk score, according to clinical activity of RA patients using DAS-28 CRP. <h3>Methods</h3> Descriptive, comparative and cross-sectional study. We enrolled RA patients between 40 and 75 years old who fulfilled ACR/EULAR 2010 classification criteria and recruited in the Rheumatology service from a tertiary care hospital, in Monterrey, Mexico. Patients were divided by time of disease evolution into quartiles. CVR results from scales were multiplied by 1.5 factor according to EULAR 2016 recommendation. Normality was assesed by Kolmogorov-Smirnov test. Variables with a non-normal distribution were described by median and interquartile range (p25-p75). Differences between groups was analyzed by Kruskal-Wallis test or Chi-squared, accordingly. <h3>Results</h3> A total of 377 RA patients were included. Demographic characteristic are shown in Table 1. An increased in acute phase reactants, CRP (p= 0.000) and ESR (p= 0.003) was found, as severity of clinical activity increased, meanwhile CVR did not show significative changes, regardless of which of scales it was measured by. <h3>Conclusion</h3> CVR did not increase according to clinical activity of RA, which suggests that such severity can not explain by itself the increased in risk showed in this population. <h3>References</h3> [1] England BR, Thiele GM, Anderson DR, Mikuls TR. Increased cardiovascular risk in rheumatoid arthritis: Mechanisms and implications. BMJ (Online). 2018;361. [2] Solomon DH, Reed GW, Kremer JM, Curtis JR, Farkouh ME, Harrold LR, et al. Disease Activity in Rheumatoid Arthritis and the Risk of Cardiovascular Events. Arthritis &amp; Rheumatology. 2015 Jun;67(6):1449–55. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0569 THE APPLICATION AND INFLUENCE FACTORS OF FACIT FATIGUE SCALE IN SLE PATIENTS
Authors: B. Issayeva, G. Koilubaeva, E. Aseeva, N. Nikishina, A. Mesnyankina, S. Solovyev, S. Issayeva, M. Bizhanova
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Fatigue is a frequent, disabling issue in systemic lupus erythematosus (SLE). It is, however, difficult to quantify. The Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale has been validated in SLE and has been successfully used to assess fatigue. <h3>Objectives</h3> To evaluate the application and influence factors of the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue) scale in patients with systemic lupus erythematosus (SLE) <h3>Methods</h3> 1061 SLE pts who fulfilled SLICC 2012 [1] criteria were enrolled into the study. The SLEDAI 2K index activity, SLICC damage index, fatigue was assessed by the FACIT-Fatigue scale from 0 to 52 (no or little fatigue 40-52, some fatigue 27-39, quite a lot of fatigue 14-26, extreme fatigue 0-13) [2] <h3>Results</h3> 1061 Lupus pts were studied, respectively. The pts were predominantly female (92%) and of indigenous nationality (Kazakh 10%,/ Kirghiz 54%/Russian 36%)with a mean±SD age 34,6±11,8 years. The mean disease duration (Мe) was 4 [1;9], the disease activity (SLEDAI 2K) 13,23±8,74, SLICC damage index 1,36±0,82. Fatigue was detected in 828 (79%) of 1061 patients with SLE. 1061 pts were divided into two groups. The first group included 447 pts with quite a lot of fatigue and extreme fatigue (from 26 up to 0 by Facit -fatigue scale). The second one included 615 SLE pts with no or little fatigue and some fatigue). The first group pts were with higher SLE activity by SLEDAI 2 K (16,4±9,3 versus 11,5±8,4; p=0,0001), had a higher level of dsDNA (131,7±23,9 versus 94,5 ± 11,7; p=0,002), were treated with higher doses of glucocorticoids (22,33±12,3 versus 19,5±17,0 mg per day; p=0,001). <h3>Conclusion</h3> Fatigue are common (79%) in SLE pts and significantly higher among Asians pts (86-94%). Fatigue strongly associated with SLE activity. <h3>References</h3> [1]Petri, M., et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis &amp; Rheumatism 64.8 (2012): 2677-2686. [2]Pilgaard, T et al. Severity of fatigue in people with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis - Results of a cross-sectional study. PLoS One. 2019, 28;14(6):e0218831 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0216 INHIBITION OF RADIOGRAPHIC JOINT DAMAGE BY JAK INHIBITORS IN PATIENTS WITH DESTRUCTIVE RHEUMATOID ARTHRITIS WITH EXTENSIVE BONE MARROW EDEMA IN HAND
Authors: K. Katayama, K. Tanaka, T. Kawahata, M. Yuichi, T. Okubo, T. Sato, S. Abe, H. Ito
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rapid radiographic progression (RRP) is considered to be one of the factors in difficult to treat rheumatoid arthritis (RA). MRI bone marrow edema has been reported to be a risk factor for RRP. We reported that extensive bone marrow edema (BE) determined by hand MRI is a prognostic indicator for rapid radiographic progression in MTX inadequate response to early RA treated with MTX+ Adalimumab combination therapy (1) and we reported biologics were more effective for radiological damage compared with MTX +csDMARDs enhanced therapy for RA inadequate response to MTX accompanying with extensive BE in hand[2]. <h3>Objectives</h3> To investigate the radiographic joint damage by usage of JAK inhibitors (JAKi) in RA patients inadequate response to MTX/ Biologics/ other JAKi with or without BE in clinical practice. <h3>Methods</h3> Twenty-four RA patients (pts) with extensive BE by hand MRI (BE group) and 30 pts without BE (non-BE group) despite treatment with MTX/biologics/JAKi were retrospectively recruited from JAK inhibitor treated pts (total:130 pts; two JAK1,3 selective inhibitor-Toficitinib(TOF):34 pts; Peficitinib(PEF):33 pts and two JAK1 selective inhibitor- Upadacitinib(UPA):35 pts; Filgotinib(FIL):28 pts). Baseline demography of patients in BE and non-BE group were shown in Table 1. Significant difference of baseline factors between BE(+) group and BE(-) group were only observed in mTSS/y (6.76 vs 3.21,P = 0.0000582, t test). Bone destruction expressed as yearly progression of mTSS (ΔmTSS/y) was determined before and after treatment by modified total Sharp scoring (mTSS) using conventional radiography. BE score measured by RAMRIS method using T1 or STIR image of hand MRI (CANON, 1.5T). Based on our previous data, extensive BE in hand was defined designated as BE score≥15[1]. <h3>Results</h3> DAS28-ESR values from baseline to 1 year was significantly reduced from 4.82 to 3.39(P&lt;0.01) in the BE group and from 4.83 to 3.45(P&lt;0.01) in the non-BE groups. After 1 year treatment by JAKi, RRP(ΔmTSS/y≥5) was more observed in 5 pts in the BE group, however RRP were not observed in the non-BE group (Figure 1). Significant differences betwwen JAK1 inhibitors and JAK1/3 inhibitors were not observed. Yearly radiographic progression observed from 6.39 to 1.59 (P=0.000003)in the BE group and from 3.21 to 0.16 (P= 0.000545) in the non-BE group. <h3>Conclusion</h3> Results of this study in the baseline and 1 year treatment indicated that BE may be a predictor of RRP not only in the MTX, biologics treatment, but in the JAKi treatment. A further prospective, randomized study may be required to clarify this. <h3>References</h3> [1]Katayama.K, ARD, supple SAT0100, 2014 [2]Katayama.K, ARD, supple FRI0124, 2018 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.